Dr. Sam Morello is on the podcast to discuss her recent publication in JAVMA, Comparison of resident and intern salaries with the current living wage as a quantitative estimate of financial strain among postgraduate veterinary trainees. Dr. Morello makes the case that early career pay plays a role in our ability to increase diversity in the profession, support women and families, reduce the frequency of burnout and increase doctor retention in the clinical space.
LINKS
Original Article: avmajournals.avma.org/view/journals/…21-07-0336.xml
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ABOUT OUR GUEST
Sam Morello received her BS and DVM from Cornell University and completed a large animal surgical residency at the University of Pennsylvania’s New Bolton Center. She spent over a decade in academia as an Associate Professor Surgery focused on musculoskeletal and upper airway diseases. In addition to her clinical research on those topics, Dr. Morello has extensive experience investigating and speaking on professional sustainability, economic, and personal life issues in veterinary medicine with a particular focus on gender. She has been an invited speaker nationally and internationally and at veterinary schools across the country. Projects have focused on women and other underrepresented groups in veterinary surgery and human orthopedics, on work-life issues for veterinarians, residency-selection and compensation, and how gender stereotypes affect perceptions of veterinary medicine to those outside. Her goals are to provide data to improve mentorship, inform career decisions, and to guide those in management and leadership roles to shape the policies that best serve the profession. She serves as the Assistant Director for Continuing Education for the American College of Veterinary Surgeons, a member of the AOVet North America Faculty where she serves on the Education Committee and leads a task force on Faculty and Leader Development for the internationally run AO Access program, a program she helped to design and launch dedicated to improving diversity, opportunity, and mentorship among global community of human and veterinary orthopedic surgeons. She also serves on the board for the Women’s Veterinary Leadership Development Initiative. Sam is now self employed as a consultant, based in Madison, Wisconsin, and recently joined the Cornell Center for Veterinary Business and Entrepreneurship as a Courtesy Associate Professor.
EPISODE TRANSCRIPT
This podcast transcript is made possible thanks to a generous gift from Banfield Pet Hospital, which is striving to increase accessibility and inclusivity across the veterinary profession. Click here to learn more about Equity, Inclusion & Diversity at Banfield.
Dr. Andy Roark:
Welcome everybody to the Cone of Shame Veterinary Podcast. I am your host, Doctor Andy Roark. Guys, I’m here today with my friend, Doctor Sam Morello and we are talking about her brand spanking new research which was published in JAVMA in January. The title of her publication is “Comparison of Resident and Intern Salaries with the Current Living Wage As a Quantitative Estimate of Financial Strain Among Postgraduate Veterinary Trainees”. That’s a mouthful. We’re talking about what interns and residents get paid in vet medicine and we’re talking about why that is important for the profession as whole, why it is the way that it is, and what it might be in the future. That’s what we’re talking about. Guys, let’s get into this episode.
Kelsey Beth Carpenter:
(Singing) This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to Cone of Shame with Doctor Andy Roark.
Dr. Andy Roark:
Welcome back to the podcast. Doctor Sam Morello, thanks for being here.
Dr. Sam Morello:
Thanks for having me, Andy. I’m excited to be back.
Dr. Andy Roark:
Well you’re going to keep coming back I hope as long as you keep putting out fascinating articles that are well researched and that help push our profession forward, so thank you for doing that.
Dr. Sam Morello:
Always my pleasure, and yeah, that’s my goal. So we’ll keep tallying these up.
Dr. Andy Roark:
So for those who don’t know, I met you at a women’s leadership summit before in the before days, before the pandemic. You have since then can continued to publish on gender equity and professional sustainability. You touch on finance and education and a number of other aspects of our profession. What have you been up to recently? How have you been through the pandemic?
Dr. Sam Morello:
So I guess I’m one of the statistics that are out there in the great, what are they calling it, the great-
Dr. Andy Roark:
The great resignation?
Dr. Sam Morello:
The great resignation.
Dr. Andy Roark:
They big quit.
Dr. Sam Morello:
Yeah. So I’ve made some professional life changes since then. I spent over a decade in academia as a large animal surgeon, and it was a great decade in my life. But I’ve decided that it was time for me to experience something different in the professional space and I wanted to see kind of how more veterinarians were actually experiencing their lives out in private practice. So I decided to move on from my academic job. I, too, now am out in the private practice realm really working for myself, doing some consulting, doing a lot in imaging space.
Dr. Sam Morello:
But I haven’t left my research efforts and passion behind. So I’m continuing that, mostly through collaborations with the Cornell Center for Veterinary Business and Entrepreneurship, where I have a faculty appointment. I’m interfacing with a bunch of new groups. I’m excited to be part of the Women’s Veterinary Leadership Development Initiative. I’m on the board now. Just making my way through that new life and excited to be there, here, and all the challenges, but new adventures that’s going to also to help me with my research.
Dr. Andy Roark:
Yeah. You stay very busy. You have a new article out in JAVMA, the Journal of VMA. It’s coming out in print in January, but the digital version is already out and it’s open to everyone. I’ll put a link in the show notes. It’s called “Comparison of Resident and Intern Salaries with the Current Living Wage as a Quantitative Estimate of Financial Strain Among Postgraduate Veterinary Trainees.” Sam Morello, in plain English, what the heck does that mean?
Dr. Sam Morello:
Yeah, so very academic title, as usual.
Dr. Andy Roark:
Extremely impressive title.
Dr. Sam Morello:
What it really means is it’s a really simple topic, which is that house officers or residents and interns get paid pretty poorly, which is something everybody knows, everybody’s known for a million years. But how poorly is a hard thing to quantify. So it’s a topic I’ve wanted to study for a long time because I think it really intersects well with a lot of the broader topics that I, and a lot of other people in our industry, have been interested in. It intersects with mental and physical wellbeing. It intersects with diversity, women and families. It intersects with how we value people in our profession and concepts of burnout and retention.
Dr. Sam Morello:
So what we did with this paper is tried to really quantitate how are individuals paid and to do that, we used a metric called the living wage. The living wage is actually a quantifiable thing. It’s an estimate or it’s that it’s actually a quantified number of essentially how much money you need to live on. It’s the line between where you’re relying on some sort of federal or state subsistence programs, subsidies like food stamps or other government programs that basically help you meet your minimum needs, like housing or food or transportation or healthcare. Just above that line is the amount of money that meets a living wage. So we used that number, which using a specific website, which I’ll get to later, that allowed us to evaluate minimum wage based on local area so we could look at it at the county level, so we could compare how much interns and residents were making in their specific location of practice to the local living wage and really compare just how much, or how little, money they were making with respect to how much money they needed to live on at a very low level.
Dr. Andy Roark:
So let me say this back to you in a different way. When we talk about living wage, we’re talking about not sustenance wage. This actually just being able to not have assistance, not have food stamps, things like that. That dollar amount is going to be significantly different depending where you are in the world, right?
Dr. Sam Morello:
Right.
Dr. Andy Roark:
Like if you’re in New York city, there is a bigger amount of money that you need to have a basic standard of life, as opposed to if you live in the Appalachian mountains in North Carolina where cost of living is extremely low. Correct?
Dr. Sam Morello:
Right. That’s exactly right. I like using the analogy there’s a Manhattan, New York and there’s a Manhattan, Kansas, and those two Manhattans are never going to be the same. So yeah, you’ve nailed it. It accounts for things like basic healthcare needs, basic lower level living. But it doesn’t account for things that most people in veterinary medicine are contending with, like certainly student loans, but even simple things like paying for a pet, their food, their vaccinations, their preventative care, seeing family, going out to eat, if you need new tires for your car. None of a living wage accounts for any of those life things that you and I, at this point in our lives I think, Andy, take for granted as something that we can pay for when it comes up.
Dr. Andy Roark:
Yeah. I want to hear a little bit more philosophically about this. I think it’s fascinating and I hadn’t really put together the larger implications. Talk to me a little bit about resident intern pay in the intersection with equity, with burnout and retention with women and families. Make that argument for me a little bit that this matters in the context of those larger issues.
Dr. Sam Morello:
So yeah, that’s actually probably a couple arguments rolled into one.
Dr. Andy Roark:
Yeah, it is a lot. But I guess, help me see through your eyes in this.
Dr. Sam Morello:
Let’s start with that. Let’s start with the burnout phenomenon. So there’s a lot of evidence out there that financial strain is deeply linked to mental health and burnout. So one great piece of evidence in the veterinary realm comes from the Merck well being studies, they have two of them actually. One came out in 2018, one came out, I think, in 2020. I think I’m getting those dates right. Volk was the primary author on those. They were able to directly link that financial strain and inadequate financial reward were two of the biggest factors that predisposed individuals in the veterinary profession to burnout. Given what we can show are the average incomes for interns and residents, they’re in the low 30s, that’s a pretty clear recipe for predisposing those individuals to burnout.
Dr. Sam Morello:
Recognizing that these are the early years of your career, especially for a resident. We’re looking at internship and residency years, so anywhere from four to five, sometimes even six years, depending on how many internships it takes to get into that residency program. That sets the ton and really can create almost a negative accrual of however you want to quantify what leads to burnout really early on in a career and can set people down a path to lower that threshold for leading to burnout.
Dr. Sam Morello:
There’s also wonderful evidence. I think wonderful is probably the wrong word for it. But there’s also very specific evidence from the American Psychological Association that financial strain is the largest source of stress for Americans year after year in this country. So I think a lot of that’s pretty implicit. Just being able to demonstrate how large that strain is, was a really important part of this study for us. So I think that gets to that burnout side of it. should we move on to the [crosstalk 00:10:43] the other stuff or you want to drill down [crosstalk 00:10:45] more on the burnout start?
Dr. Andy Roark:
No. I think that’s good. I think, to me, that makes a lot of sense. Especially, I think what I really needed to hear was the point that we were talking about the beginning of people’s careers and the ripple effects and we talk about compounding and opportunity costs where you could be doing other things. It sets off a career trajectory. So I guess that makes a lot of sense to me as to why we would see the downstream effects of resident/intern pay that we see.
Dr. Sam Morello:
Yeah. To actually to make a comment on what you just said, you said “compounding effects”, there’s this idea of almost needing to play catch up later. So you have these years of sometimes we refer to it as lost income. So these four or five, six years, you’re making very little money, your debt is accruing, or you’re accruing more debt sometimes. Because something we showed in this study is that for some people, the amount of money that they’re earning is actually less than what a living wage might be in the area that they’re living in for I think between 15% of residents and 22% of interns their pretax income was less than what their local living wage was. So that’s a pretty high percent of individuals who may not be able to meet their living needs.
Dr. Andy Roark:
These are people working at specialty hospitals, working in universities with teaching positions, a lot of them. I remember in vet school, residents did a lot of the teaching and the mentoring, and things like that.
Dr. Sam Morello:
Yeah, absolutely. They’re working in big, well respected hospitals and they’re taking on a lot of the same duties that specialists are. So they may be accruing even more debt aside from what their interest rate is already doing for them, for those of them that come in with debt. So the years afterwards, trying to play catch up to get out of that debt or to make the money that they didn’t make over those years, to say nothing of the amount of money that they weren’t able to put towards a retirement account.
Dr. Sam Morello:
A goo friend of mine, Doctor Brent Mayabb, he’s one of the chief medical officers at Royal Keenan, he’s really invested in, in personal finance and in helping young veterinarians tackle that issue. He did some great rough calculations, back of the napkin sort of calculations, for me to show what a hypothetical loss of retirement savings might look like for an average resident. Hypothetically, if you were not doing an internship or residency and you were saving $200 a month, so about $2,400 a year, versus if you were doing an internship and residency and you weren’t saving that much money over 4 years, it’s only a difference of somebody who might be saving about $9600 over those 4 years, versus somebody that isn’t. But that $9,600 over the course of a career where you retire at 65, with an 8% compounding interest rate could add up to almost $200,000 by the time you retire. So that loss of income, just trying to catch up to that over the course of your career, that’s an added stress in and of itself. That’s a stress that’s going to stay with you over time.
Dr. Andy Roark:
Hey gang, I just want to jump in here with a couple of quick updates, big stuff going on. First of all, I got to thank Banfield Vet Hospital. Guys, through a generous grant from those guys, we are able to provide transcripts of both the Cone of Shame Vet Podcast and the Uncharted Veterinary Podcast. They’re doing this in the spirit of inclusivity and increasing accessibility to resources in the vet space. So we were the beneficiaries of their generosity and we are able to have transcripts for everybody who wants to see them. You can head over to drandyroark.com or unchartedvet.com. Follow us on social media, and you’ll see these when they come out. But we are going to be linking the transcripts just to make these podcasts accessible to anyone and everyone who wants to participate, who wants who wants to check them out.
Dr. Andy Roark:
Other updates that are important. Number one, strategic planning all up on you. If you’re looking at 2022, and you’re like, “I wish I had a plan,” we should figure some things out about what we’re doing so we’re not just putting out fires, but instead, doing things that are actually important that we want to do. Guys, I got you covered, but you got to act fast. I am doing workshops. I’m doing four workshops on strategic planning with my wing man, the one and only practice management goddess, Stephanie Goss. The first one is on January the 26th. The second one is February 9th, February 23rd, and March 9th. They all have different focuses. The first one is on running a strategic planning meeting for your team. It’s how do you get your people together and talk about where your business is going and make some decisions. That is the one that I’ll be doing on January 26th with Stephanie Goss, you can register for them separately. They are $99 each to the public or buy them together as a bundle for $299. They are free to Uncharted members, so if you’re like, “I want to do them all and I’ve been putting off being an Uncharted member,” this is a great reason to get on board and do it. So strategic planning workshops, I would love to see you there. They are super hands on, super active, super useful. So that is going on. Don’t miss them. You got to register. Especially if you do the bundle, grab them both before the first one goes.
Dr. Andy Roark:
The April Uncharted Vet Conferences in Greenville, South Carolina. We are back in person. It is our homecoming, and that’s the theme, it’s homecoming. The five year anniversary of Uncharted is going to be a great time. We are going to cap attendance at 100 or less just to keep everybody safe. But we’re still going to get together and do a wonderful conference. If you’ve never been to an Unchartered conference, they are super magical. It is not like other conferences. It is very active, very engaged. You are going to meet people. You are going to make friends. You are going to talk about your business.
Dr. Andy Roark:
The theme of this conference in April is all about running smoother, more enjoyable, more rewarding practices. It’s not about getting more customers. It’s not about working harder. It’s not about finding things to do that you’re not doing. It’s about doing less things and making the things that you do now go more smoothly. So if you’re like, “Oh, that sounds good, I’d like to be a part of that,” get over to unchartedvet.com, get registered for the conference. You do have to be an Uncharted member to come to that, but you can grab your membership, get on board with, the conference. It is something super special. You do not want to miss it.
Dr. Andy Roark:
And finally, over on the Uncharted Veterinary Podcast, that is the podcast I do with my buddy, Stephanie Goss, we are talking about is human health insurance the problem with getting people to do pet insurance. Steph and I both believe that getting people to get their pets insured is a great way to ensure that those pets get the care that they need. Getting more clients insured means getting more pets that have resources to get the care that they need, which means we get to do the job and the work that we really want to do and that we enjoy doing. So we get into this with our special guest, Melissa Gutierrez, and we talk about the barriers to getting people on board with pet health insurance. If you’re like, “Hey man, I’d like to get more of your going pet health insurance up in my practice,” head over there, check it out. Subscribe to Uncharted. It is a great podcast, totally free. We’d love to have you on board. With that, I think that’s enough, let’s get back into this episode.
Dr. Andy Roark:
What’s the median age range for interns and residents? We’re talking about people who are what, 28 to 32-33 years old? Is that the basic age range for these people?
Dr. Sam Morello:
Yeah. So every year about a 1000 people, just over 1000 people, match into internships through the VIRP. That’s out of about 3,200 people that are graduating from veterinary schools. So I’m not exactly sure what the average age of veterinary school graduates are right now, but it’s somewhere in the mid to late 20s. For residencies, it’s just over 300 people. So about a third of those internships are matching people into residencies. Again, it’s taking some people anywhere between one and three internships. So if you add that on, yeah, most people that are finishing their residencies are probably around the age of about 30 or a little bit older.
Dr. Andy Roark:
How big is the variance in income among programs? Are they pretty uniformly low paying programs? Are there some private practice residencies and interns out there that have a very different financial picture? Help me understand that.
Dr. Sam Morello:
Yeah, that’s a great question. We address that in our paper. So when you look at academia, it’s a pretty tight narrow band. Most of the programs exist within a pretty narrow band, somewhere in the 30s, with an average salary I think somewhere around $34,000. But in private practice, the range is much, much larger. I believe the range was somewhere between the low 30s and all the up to about %75,000.
Dr. Sam Morello:
I think there’s a whole lot more flexibility, of course, in private practice. An individual private practice may take one resident in one specialty or they may take multiple residents in multiple specialties, versus an academic program, which is likely to populate most of their specialties with multiple residents. So there’s a different financial sort of commitment, I think, for the different hospitals. But there’s clearly much more flexibility you in setting salaries in that private or corporate structure.
Dr. Andy Roark:
Yeah. Well when we start to talk about internship and residency programs and the salary structure that we have, I guess, how do you explain the position that we’re in there? So if you say to me, “Hey, a significant percent of people doing residencies, internships are making below living wage.” If I said to you, “Why,” how would you answer that question?
Dr. Sam Morello:
I think there’s a not great answer, which is that it’s because the way we’ve always done it. It’s the way we’ve always done it. And-
Dr. Andy Roark:
That’s what it feels like, is residents and interns, they work on all the time and they don’t make any money, and that’s the way it’s always been. But as the economics of vet medicine have changed is there a reason that’s persisting?
Dr. Sam Morello:
Yeah. I think the other also not great answer is unfortunately, that we use the term in the paper that it’s a monopsony like market, which means you have a captive audience, The people that really want to do residencies and internships and have the ability to make the choice to do that, and I think that’s a very important point that we should revisit, but I’m not going to drill down on it with the rest of this statement, are going to do this program no matter what. So it’s not going to matter if you offer them $25,000 or $40,000 or $65,000, they will figure out a way to do it.
Dr. Andy Roark:
Yeah, they’ll say, “Yes.” They’ll take the seat.
Dr. Sam Morello:
Right.
Dr. Andy Roark:
Isn’t that a big part of of our student debt problem, as well, is that you have so many people who are so motivated and they’re going to take the spot, come hell or high water? I’ve struggled with that a lot is you say, “Well, there’s the autonomy part,” the responsibility part, I guess where people say, “I know what I’m signing up for and I’m signing up for this.” There’s another part where you go, “Ah, but it feels more complicated than that.” I love the term monopsony like market. I’m going to incorporate that into daily speech. I’m in love with this term. But it does feel like a monopoly like if you want to be a vet, there’s only one path to do it and if you want to be a specialist, there’s only one path to do it and there’s not a lot of opportunities. You really have no leverage as you would in a larger market.
Dr. Sam Morello:
Yeah. It’s almost like Shakespeare wrote this tragedy into the profession where everybody’s so passion driven that it’s going to, at some point at, play negatively against what’s best for us in the end, and that is what happens. Everybody is so dedicated to the animals, to their education, and honestly, to each other. This gets outside of, of course, just interns and residents, that it’s against rational thinking. It’s behavioral economics at its finest that it’s irrational, but we all do it anyway.
Dr. Andy Roark:
You see it a lot in technicians and assistants. We talk about the percentage of technicians and assistants that make below a living wage, and there’s a high percentage.
Dr. Sam Morello:
Correct.
Dr. Andy Roark:
You say, “Well, why do they do this? Why don’t they go somewhere else?” I do feel like that passion, that desire to be a part of this specific profession, it almost holds our feet against the fire, not in a good way, of I don’t want to leave because I love this, or this is what I feel called to do. I feel like calling has become an increasingly loaded term. I’ve started push back against calling that medicine a calling because I think it feeds that belief like this is my passion and I don’t have any other options. I feel like when we don’t feel like we have any options that’s when we start to feel trapped. I think that’s a big part of burnout.
Dr. Sam Morello:
I think it’s a way of describing it. I had a colleague tell me once, “Dreams are nightmares too,” because we all talk about how these are our dreams and we follow our dreams. I believed in that my whole life. That’s why I became a veterinarian, that’s why I went down the paths I went down, and that’s great. But that’s not always necessarily going to lead you down the path of making choices that are going to optimally support your ability to live a safe or secure life that can support the other choices you want to make. The choice that you make when you’re 25 or 30 is not necessarily the choice you would make when you’re 40 or you’re 50. But your 40 or 50 year old self has no ability to inform that person or vice versa. It’s hard to mediate those things or have to clean up the choices or account for them later on. Unfortunately, finances are things that end up being a constant thread and permeate a lot of life in a continuous way.
Dr. Andy Roark:
You can’t make up for lost time when you’re talking about compounding, you’re talking about building wealth, you’re talking about retirement, things like that.
Dr. Sam Morello:
Right.
Dr. Andy Roark:
I have those thoughts a lot, if I could go back and talk to my younger self what would I say? The more interesting question I think is if you could go back and talk to your younger self, what would your younger self hear and understand? I think that’s a harder question than what would I say, because I know what I would say. I think knowing younger Andy, I think it would all go right over his head or he would just be like, “That’s ridiculous.” I would not [crosstalk 00:27:12] take future Andy seriously at all, I would not have. I would’ve been like, “That’s ridiculous”.
Dr. Andy Roark:
Knowing who you are at 20 and 25, what is possible in that phase of our life? Because once that phase is over, it’s passed. I hear this cynical voice in my head that I’m sure that when we talk about intern and residency, compensation comes back and they say, “But they’re going to be a specialist.” This is, yes, this is a bump in the road, but won’t the ultimate outcome be so worth it and make this up? I know that’s beyond the scope of the research that you published, but are you comfortable speaking to that a little bit of the financial picture coming out of a residency/intern program?
Dr. Sam Morello:
Yeah.
Dr. Andy Roark:
Is it the bounce back phenomenon that we like to think that it would?
Dr. Sam Morello:
Yeah. So I think there are a lot of things that go into that. One, I think that it needs to be another element of this conversation that every decision we make, finances play a role in it, but it’s not the only thing that plays a role. Certainly, that’s true for becoming a specialist. I’ll get into that a little bit more I think later. But the financial outcome of specialty medicine is it’s not universally lucrative. There are certain specialties where you can bank, literally bank, on coming out and making quite a lot of money. I’ve generated some of that evidence through previous publications. We published on some of the professional and personal life integration and finances for ACVS and ACVIM diplomates, and certainly small animal surgeons, neurologists, cardiologists. Those are individuals who come out and make quite a bit of money, or the average and median incomes for those individuals are quite high. That data is just a couple years old now. We know that with the economic boom and the competitive market for those specialists right now, those numbers are only getting higher, and certainly anecdotal evidence for starting salaries for those individuals is just fantastic.
Dr. Sam Morello:
But it’s not quite the same for some of the large animal surgeons. There’s some new data that’s actually also out on JAVMA now for zoo med veterinarians, which shows that the average salaries are not very high. So it’s not universally lucrative. Then when you start to factor in the other personal life choices about how much do you want to work, are you taking time out of the workforce in those early years to start a family, are you taking time out more than once to start a family? That’s time that you’re not necessarily going to be earning money. It looks different depending on where you work, how you work and how you want to work. So do you want to have to be tied to a certain way of working? There are only so many people that can become a certain type of specialist in any given year, so it’s not universally lucrative.
Dr. Andy Roark:
Where do you see possibility here? With the takeaways when we’re looking at this, and we say, look at the strain that we’re putting on our young and recent graduates who are going into advanced training, what do you think is possible? What do you think it takes to right the ship or to make significant headway in setting our colleagues up for success?
Dr. Sam Morello:
I think that there are a couple big topics and, ideally, movements that should come out of this. One of them, of course, the biggest one, of course, is improving the incomes for interns and residents. We’ve said for a long time that interns and residents cost money because they’re not fully trained veterinarians, they slow us down. That’s part of the reason that their incomes or their salaries are so low.
Dr. Sam Morello:
I think that if most of us who worked in big specialty hospitals look back over the last couple years during the pandemic and figure out how our hospitals stayed afloat, and even look at the years when there wasn’t a pandemic and look at how we worked and how emergency rooms stayed functional, especially in hospitals, where there are interns and residents, I think we can all see how valuable those individuals certainly have been recently, and really have always been towards keeping the workflow in a positive direction and generating revenue, and, as you mentioned earlier, supporting the teaching mission in a lot of hospitals. I think if we were to be able to quantify some of that, it would demonstrate that they much more than generate their own income, and generate a much higher income.
Dr. Sam Morello:
We talk about in the paper, some other examples of how postgraduate medically or scientifically educated trainees in this country, both MD residents, and also those undergoing postgraduate training programs like through the NIH, how those individuals are valued by which, I mean, what sort of incomes are they making. So I think that there are ways to quantitatively value their time in a much more supportive and effective way. I think making that step would go a long way towards supporting these individuals.
Dr. Sam Morello:
Which I think leads me to the second point, which I think is really important. The choice to do an internship for residency is really multifactorial. It’s not just do I want to make a lot of money as a specialist or do I want to or not want to make so little money as an internal resident. I think that there are a lot of people out there that don’t feel that they can spend those years making so little money. They either have a lot of debt, they have other responsibilities. It’s a stressor they don’t feel that they can take on for other reasons, which essentially means there’s an entire population where we have limited their professional choices. So it’s not a choice that I believe is open to everybody. What we want to do in veterinary medicine is leave that choice open to everybody. We want every choice to be on the table. It doesn’t mean everybody will match into whatever program they want to. But the choices should be there for everybody and they should be comfortable for everybody, and that’s not what we’ve created.
Dr. Sam Morello:
So creating a more stable economic situation for postgraduate veterinary trainees creates a more equitable future and more equitable opportunity for everybody in the profession, no matter what their background or current situation or future situation would be, and I think that’s very important.
Dr. Sam Morello:
Then I think the third part of that gets into what you mentioned earlier, which is the idea of diversity supporting women, supporting families. Lisa Greenhill, and James Lloyd put together the AAVMC, I think, focus on diversity report this last year. It showed that black indigenous people of color and PELL grant students were more likely to enter veterinary school carrying debt and carrying a higher volume of debt than white students, which means that those individuals their threshold for being able to accrue more debt or take on a position that imposes more financial strain is likely to be lower at the end of veterinary school.
Dr. Sam Morello:
We already see that there’s much lower representation of people of color and various ethnicity in specialties. I’ve generated quite a bit of that data in my previous research reports and there’s a lot of that coming out over the past year or so since some of the specialty colleges have been effective at putting together their own commissions and there have been some great new groups popping up to work on the really important diversity issues that we have. So that means that’s one of the big groups that we are limiting choice to and limiting opportunity from, we’re just creating another barrier, essentially.
Dr. Sam Morello:
I think that’s true also for women, families, anybody that has children. A salary in the low $30,000s is hardly going to cover childcare for people. So unless they have a partner who can really carry the entire load of the family, it might not be an option for those individuals. We see that women specialists are less likely to be married or have children and very, very few of them have children during residency, and even a relatively small proportion of men have during residency. So again, we’re limiting opportunities for a large portion of our workforce.
Dr. Andy Roark:
Doctor Sam Morello, thank you so much for being here. Thanks for talking with me as always. Are there any last points, words of wisdom, pieces of advice that you’d like to leave us with?
Dr. Sam Morello:
I think the 10,000 foot perspective on this is that we need to think about how we value the time, education and work of really everybody in our profession, that’s not just the interns and residents, that’s the technicians, it’s some of our general practitioners. If we can’t value ourselves in each other, then how do we ask people outside of our profession to value us? So this is a holistic idea. This is about all of us and this is the time to take a harder look at that idea. There are a lot of people in this profession that we need to think about when we think about that and a lot of corners of the profession that we need to solve that problem for.
Dr. Andy Roark:
No, I completely agree. Thank you so much. Your article “Comparison of Resident and Intern Salaries with the Current Living Wage as a Quantitative Estimate of Financial Strain Among Postgraduate Veterinary Trainees” is out online in JAVMA. I put a link in the show notes. It’ll be out in print January one. Thank you again for being here.
Dr. Sam Morello:
Thanks so much Andy.
Dr. Andy Roark:And that is our episode. Guys, I hope you enjoyed it. I hope you got something out of it. As always, the best kindest, nicest thing you can possibly do for me if you liked the episode is to leave an honest review on iTunes, or wherever you get your podcast episodes. It’s how people find the show. It gives me some guidance about what people and it keeps me encouraged to keep doing the episodes. So I really appreciate it. Guys, take care of yourselves. Be well. I’ll talk to you soon.
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